VoxxArrive · Saudi Arabia onboarding topic
Mandatory Health Insurance for Expatriate and Private-Sector Saudi Employees in Saudi Arabia: A CCHI/CHI Employer Guide (2025-2026)
Saudi Arabia mandates cooperative health insurance for private-sector employees under the Cooperative Health Insurance Law (Royal Decree No. M/10, 1420H/1999). The mandatory scope covers non-Saudi (expatriate) employees under Article 3 - where valid coverage is also a legal precondition for issuing or renewing the employee's Iqama (residence permit) - and, separately, Saudi nationals employed in the private sector plus their eligible family members, brought into the scheme by Council of Ministers Resolution No. 206 (dated 15/08/1423H) and codified in Article 2 of the Implementing Regulations; this is settled law, not a future or conditional extension. The scheme was created and administered by the Council of Cooperative Health Insurance (CCHI), later rebranded the Council of Health Insurance (CHI). As of March 4, 2024, the Insurance Authority (IA) took over "all health insurance responsibilities" from CHI, per CHI's own transfer announcement and multiple legal/industry sources - yet CHI's own October 2025 release on Q3 2025 employer penalties still names "Council of Health Insurance (CHI)" as the issuing body, so which functions each body currently exercises is not fully resolved in public sources. The regulator sets a minimum benefits package under Article 7 covering clinic/outpatient treatment, preventive and maternity care, diagnostics, hospitalization and surgery, and basic dental treatment. Under Article 14, an employer who fails to enroll staff or pay premiums must pay all unpaid premiums plus a fine of up to one year's premium ("annual subscription") per employee, and can be barred from recruiting foreign workers; the regulator (branded CHI in the announcement) reported issuing 140 such penalty decisions against employers in Q3 2025 alone, totaling SAR 828,321,011 - a figure corroborated across multiple independent reprints of the same wire story though the primary SPA page could not be fetched directly this session (403 response).
Steps
- Identify who must be covered - Confirm which employees are non-Saudi/expatriate hires - mandatory scope under Article 3 - and list their eligible dependents. Saudi nationals employed in the private sector, plus their family members, are also mandatorily in scope: Council of Ministers Resolution No. 206 (dated 15/08/1423H) already extended the mandate to them, and this is codified in Article 2 of the Implementing Regulations - it is settled law, not a future or conditional extension.
- Buy a policy meeting the Article 7 minimum benefits package - Purchase from a licensed Saudi health insurer a policy covering, at minimum, clinic/outpatient treatment, preventive and maternity care, diagnostic testing, hospitalization and surgery, and basic dental/gum treatment (orthodontics and dentures are excluded from the statutory minimum).
- Enroll before applying for or renewing the Iqama - For non-Saudi employees, get coverage active before requesting the residence permit - Article 3 makes valid insurance a precondition for Iqama issuance and renewal. (Saudi private-sector staff are covered under the same mandate but have no Iqama linkage.)
- Pay premiums and keep coverage continuous - The employer bears the premium cost; a lapse exposes the employer to Article 14 liability - all unpaid premiums plus a fine of up to one year's premium per employee.
- Give written notice before switching or cancelling an insurer - Under the Implementing Regulations, notify the insurer and the regulator - named as CHI in the Implementing Regulations text, though the Insurance Authority (IA) took over health-insurance responsibilities from CHI in March 2024, so confirm the current notification channel - in writing at least one month before cancelling or changing a policy.
- Keep records ready for compliance checks - The regulator can request documentation to verify enrollment and premium payment, and has been running active enforcement sweeps - 140 employer penalty decisions in Q3 2025 alone, announced under the CHI name even though the Insurance Authority formally took over health-insurance responsibilities from CHI in March 2024 (see regulators note).
Timeline
Not a one-off filing: coverage must stay continuously active for the duration of employment and, for expatriate staff, is checked at every Iqama issuance/renewal cycle. The regulator runs ongoing enforcement (140 employer penalty decisions cleared in Q3 2025 alone, announced under the CHI name), so a lapse can be flagged well before the next annual Iqama renewal rather than going unnoticed for years. Note: health-insurance oversight formally moved from CHI to the Insurance Authority (IA) on March 4, 2024, so the specific body an employer deals with day-to-day may differ from what older guidance assumes.
Cost & fees
The law places the full premium cost on the employer; premiums themselves are set by individual licensed insurers and vary by employee, coverage tier and insurer rather than a fixed government fee. Non-compliance cost is fixed by statute: all unpaid premiums plus a fine of up to one year's premium (the 'annual subscription') per uninsured employee (Article 14). The Q3 2025 enforcement round totaled SAR 828,321,011 across 140 employer decisions, announced under the CHI name; note that health-insurance regulatory responsibility formally transferred from CHI to the Insurance Authority (IA) on March 4, 2024, so confirm current jurisdiction before assuming CHI is still the body you'd deal with for an appeal or dispute.
Some figures on this page vary by jurisdiction, zone or nationality, or could not be independently confirmed from a public source at time of writing - confirm the current figure with the regulator before relying on it.
Sources
- Saudi Press Agency - "Council of Health Insurance Announces Penalties for Q3" (Oct 27, 2025)
- Cooperative Health Insurance Law, Royal Decree No. M/10 (full text)
- Implementing Regulations of the Cooperative Health Insurance Law (amended) - confirms Article 2 mandatory-beneficiary categories including Saudi private-sector employees under Council of Ministers Resolution No. 206 (15/08/1423H)
- Al Mustashar - "Saudi Health Insurance: Employer Obligations & CHI Rules"
- Saudi Expats - "Health Insurance Guide 2026"
- GCC Business Development Institute - "Saudi Insurance Authority Has Now Become the Sole Regulator of the Insurance Sector"
- Lexis Middle East Law Alert - "KSA: Insurance Authority Now Responsible for Health Insurance" (March 8, 2024)
Frequently asked
Which employees in Saudi Arabia must have mandatory health insurance?
Under Article 3 of the Cooperative Health Insurance Law, private-sector employers must enroll their non-Saudi (expatriate) employees and eligible dependents in an approved health insurance policy; coverage is a precondition for issuing or renewing the employee's Iqama. Saudi nationals employed in the private sector - and their family members - are also mandatorily covered: Council of Ministers Resolution No. 206 (dated 15/08/1423H) already brought them into the scheme, and this is reflected in Article 2 of the Implementing Regulations. So the mandate is not expatriate-only; it effectively covers the private sector as a whole.
What minimum coverage must an employer's policy include?
Article 7 sets a minimum benefits package: medical checkups and clinic treatment, preventive care and maternity services, diagnostic testing, hospitalization and surgery, and basic dental/gum treatment - orthodontics and dentures are excluded from this statutory minimum.
What happens if an employer doesn't insure a worker or stops paying premiums?
Article 14 makes the employer liable for all unpaid premiums plus a fine of up to one year's premium per uninsured employee, and the regulator can temporarily or permanently bar the employer from recruiting foreign workers. The regulator (branded CHI in the announcement) reported 140 penalty decisions against employers in Q3 2025 alone, totaling SAR 828,321,011 - a figure corroborated across several independent reprints of the same wire story, though the primary spa.gov.sa page returned a 403 error on direct fetch this session.
Who regulates mandatory health insurance in Saudi Arabia - is it still called CCHI?
The scheme was created and administered by the Council of Cooperative Health Insurance (CCHI), later rebranded the Council of Health Insurance (CHI). As of March 4, 2024, the Insurance Authority (IA) took over "all health insurance responsibilities" from CHI - per CHI's own transfer announcement and corroborating legal/industry sources - and now positions itself as the Kingdom's sole insurance-sector regulator, including health-insurance complaints and enquiries. However, CHI's own October 2025 release announcing Q3 2025 employer penalties still names "Council of Health Insurance (CHI)" as the body issuing the enforcement decisions, so it's unclear from public sources whether CHI retained the Article 14 employer-enforcement function specifically or whether this is legacy branding. Employers should verify current jurisdiction via both chi.gov.sa and ia.gov.sa before relying on either name alone.